| NPI | 1588619647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 420008813) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 9042) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2024-12-02 |