| NPI | 1023087566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 220572) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD15209) |
| 207Q00000X Family Medicine (Licence: NY 282496) | |
| 207Q00000X Family Medicine (Licence: ME MD20873) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2016-02-22 |