| NPI | 1396777199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042.0013862) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 206374) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-12-08 |