| NPI | 1962066878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME179335) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: RI LP04636) | |
| 207Q00000X Family Medicine (Licence: RI MD18615) | |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2026-07-08 |