| NPI | 1275972127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101027527) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 63536-21) |
| 207Q00000X Family Medicine (Licence: VT 032.0133880) | |
| 207Q00000X Family Medicine (Licence: NH 21790) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2024-02-21 |