| NPI | 1376839332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 032.0133921) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT014123) |
| 207Q00000X Family Medicine (Licence: CA 20A13173) | |
| 207Q00000X Family Medicine (Licence: MA 293296) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2022-10-20 |