| NPI | 1033555180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA DO.OP.60907096) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 032.120491) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2022-06-16 |