| NPI | 1417979535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD446384) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 042-0009417) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2018-03-28 |