| NPI | 1821582024 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD18396)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 238204)  | 
| Enumeration Date | 2018-06-20 | 
| Last Update Date | 2024-08-30 |