| NPI | 1083861181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0075608) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD13627) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2022-01-24 |