| NPI | 1922480821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD16324) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 264650) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2021-09-15 |