| NPI | 1255301016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042-0009782) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2005-00643) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2011-04-22 |