NPI | 1255314167 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042-0011674) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 158362) |
Enumeration Date | 2005-11-23 |
Last Update Date | 2014-11-24 |