| NPI | 1023402674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD24440) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 042-0014254) |
| Enumeration Date | 2015-03-21 |
| Last Update Date | 2021-12-08 |