| NPI | 1255053211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD UMAIR MALIK CEO/Owner 802-500-6923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-09-16 |
| Last Update Date | 2024-07-16 |