| NPI | 1346614237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 169007-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 032.0104809) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2022-07-21 |