| NPI | 1770568206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 80030) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD11689) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2018-04-02 |