| NPI | 1912045170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 246634) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD13457) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2012-04-30 |