| NPI | 1033161799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS9218) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME DO3562) |
| 207Q00000X Family Medicine (Licence: VT 032.0134116) | |
| 207Q00000X Family Medicine (Licence: MA 1019043) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2024-10-18 |