NPI | 1326030099 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME163663) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 042.0013060) |
207Q00000X Family Medicine (Licence: NH 10816) | |
Enumeration Date | 2005-08-18 |
Last Update Date | 2024-01-17 |