Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 042-0007766 | VT |
NPI | 1003994633 |
---|---|
Provider Name | Dr. Julie Jae Olin |
First Address | Essex Junction, VT 05452-2741 |
Second Address | Morrisville, VT 05661 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |