| NPI | 1649353731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 0420011598) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 14043) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2024-06-12 |