| NPI | 1083008445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 300133) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD16187) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2021-06-03 |