| NPI | 1265420442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD09062) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 152833) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2020-04-20 |