| NPI | 1679767453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD13042) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA Mt188960) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2009-07-27 |