| NPI | 1528192986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 14485) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VT BF4323200CW) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2010-03-11 |