| NPI | 1871013839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 11414333-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP04109) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2019-09-12 |