| NPI | 1639153596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 231054) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD11384) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2020-04-22 |