| NPI | 1881829604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 099.0076668) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA ND0019) |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2025-10-06 |