| NPI | 1679863609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD18590) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A122363) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2023-02-17 |