| NPI | 1477896108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042.0014590) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 265497) |
| 207Q00000X Family Medicine (Licence: NH 19474) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2020-04-15 |