| NPI | 1720584220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 287470) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP04414) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2021-07-20 |