| NPI | 1962589432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0095650) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 0420010047) |
| 207Q00000X Family Medicine (Licence: NJ 25MA06802900) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-05-02 |