| NPI | 1578824769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 302674) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD16581) |
| 207Q00000X Family Medicine (Licence: MA 264851) | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2021-04-06 |