| NPI | 1992790067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042-0011825) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301069175) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2023-10-13 |