| NPI | 1497722862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042-0009836) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: VT 042-0009836) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2013-08-09 |