NPI | 1336123587 |
---|---|
Former Name | PEARL CHRISTIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.32028) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101235022) |
207Q00000X Family Medicine (Licence: TX N6225) | |
207Q00000X Family Medicine (Licence: FL ME110535) | |
Enumeration Date | 2005-12-01 |
Last Update Date | 2016-08-15 |