| NPI | 1568606416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 0420012791) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A109764) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2021-12-29 |