| NPI | 1619914413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD16438) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 217621) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2018-12-17 |