| NPI | 1740700780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 1024684) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP04111) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2026-03-20 |