| NPI | 1134173206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: RI DO 00619) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI DO00619) |
| Enumeration Date | 2006-05-21 |
| Last Update Date | 2019-02-28 |