| NPI | 1679831937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD15987) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD164793) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2025-06-23 |