| NPI | 1720059025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: MA 224401) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: RI MD12505) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2022-09-06 |