NPI | 1205941879 |
---|---|
Entity Type | Organization |
Authorized Contact | KATHY L DETZER Bus Manager 802-296-7370 |
Organization Subpart ? | No |
Primary Taxonomy | 208800000X Urology (Licence: VT 0420008456) |
Additional Taxonomies | 208800000X Urology (Licence: NH 8746) |
Enumeration Date | 2006-08-21 |
Last Update Date | 2007-07-17 |