| NPI | 1992759823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE VISELLI Owner 802-872-7001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2008-01-09 |