| NPI | 1912075896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042-0012309) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 9959) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2016-04-26 |