| NPI | 1265402382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042.0011317) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 209588) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2023-06-30 |