| NPI | 1376808766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI DO00773) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 260056) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2014-12-09 |