| NPI | 1770542631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042-0012154) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 219879) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2011-08-23 |