| NPI | 1790715654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 38126) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD07115) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2026-08-03 |