| NPI | 1770845315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101261443) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD15157) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2022-07-21 |