| NPI | 1972559904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE MCKELLAR Administrator 603-663-5248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2009-06-05 |