| NPI | 1104484351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 24398) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP04695) |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2023-08-29 |