| NPI | 1972524445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 12068) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 0420011250) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2016-01-11 |