| NPI | 1164418455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAMAL H ELTABBAKH President 802-859-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2013-05-23 |