| NPI | 1578780060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI 12275) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 238230) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2023-01-25 |