| NPI | 1194859421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-40241) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 0420011375) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2024-03-27 |