| NPI | 1730521493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON CHARLES BLACK Owner/ Administrator 603-287-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 037311-23) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-12-11 |