| NPI | 1578212429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD20555) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC MMD.87770) |
| Enumeration Date | 2022-03-19 |
| Last Update Date | 2025-04-25 |