| NPI | 1811000953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301102021) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP00965) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2022-01-12 |