| NPI | 1689194631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301509984) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP04116) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2023-10-26 |