| NPI | 1245202548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 0420008830) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VT 0420008830) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2007-07-08 |