| NPI | 1659716256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MD D82165) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 042.0017890-COMP) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2025-09-18 |