| NPI | 1003432212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD19318) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351046058) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2023-07-18 |