| NPI | 1245202548 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 0420008830)  | 
| Additional Taxonomies | 208D00000X General Practice (Licence: VT 0420008830)  | 
| Enumeration Date | 2006-02-02 | 
| Last Update Date | 2025-09-11 |