| NPI | 1932635562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD18765) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 283045) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2025-09-18 |