| NPI | 1811125081 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD14032) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 257304) | 
| Enumeration Date | 2009-06-26 | 
| Last Update Date | 2025-08-25 |