| NPI | 1073690517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 023467) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD16184) |
| 207Y00000X Otolaryngology (Licence: CT 023467) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2024-12-09 |