| NPI | 1962723205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD16669) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: RI MD16669) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2021-04-09 |