| NPI | 1962519108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042-0011994) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME 017878) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2016-09-01 |