| NPI | 1104111426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 258099) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP02152) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2014-12-15 |