| NPI | 1679545446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME 016522) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD07436) |
| 207Q00000X Family Medicine (Licence: MA 70463) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2015-06-17 |