| NPI | 1497040711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-01963) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP02155) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2018-05-30 |