| NPI | 1780662171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00041649) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 420010987) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2023-03-07 |