| NPI | 1760758734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 0420013581) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A129074) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2016-09-09 |