| NPI | 1467747816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 258751) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP02230) |
| 207Q00000X Family Medicine (Licence: RI MD14642) | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2026-06-26 |