Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0420009583 | VT |
NPI | 1003806480 |
---|---|
Provider Name | Elizabeth Linder |
First Address | Townshend, VT 05353-0216 |
Second Address | Townshend, VT 05353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 19/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G60572 | (02) |