| NPI | 1982907879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 253170) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD15158) |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2018-03-17 |