Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 0420010024 | VT |
NPI | 1174516397 |
---|---|
Provider Name | Sarah Perkins Dahl |
First Address | Bennington, VT 05201-2265 |
Second Address | Bennington, VT 05201-2265 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H26401 | (02) | |
OVN2421 | (05) | VT |