| NPI | 1558334656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 0525322303) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 1010030222) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2013-10-24 |