| NPI | 1679951354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 278239) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03301) |
| 208000000X Pediatrics (Licence: RI LP03301) | |
| 208000000X Pediatrics (Licence: MA 278239) | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2019-06-26 |