| NPI | 1962908483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0099980) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP04394) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2025-04-11 |