| NPI | 1003929639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 064942) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP00094) |
| 207Q00000X Family Medicine (Licence: MA 238303) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2017-02-01 |