| NPI | 1952780314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY ELIZABETH VON LEPEL Owner 802-849-2844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 0420007724) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2015-05-19 |