| NPI | 1871087619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY M JANKO Administrator 603-921-4947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2023-08-21 |