| NPI | 1962415042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: VT 042.0009355) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 0420009355) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2013-09-17 |