| NPI | 1770505661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE THERESE MICHAELS Surgical Pa 802-295-9363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NH 343) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-08-22 |