| NPI | 1760448450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042-0011915) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 8165) |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2010-02-23 |