| NPI | 1023675337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD19963) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L.5441) |
| 208600000X Surgery (Licence: IA R-11521) | |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2025-07-18 |