| NPI | 1063859270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD19407) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD456948) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2023-12-08 |