| NPI | 1932343944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 032.0133794) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 56329-021) |
| 207Q00000X Family Medicine (Licence: NY 269075) | |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2023-07-08 |