| NPI | 1356667570 |
|---|---|
| Former Name | CAROL ROSE DWAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 201400181) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101255559) |
| 207R00000X Internal Medicine (Licence: VA 0101255559) | |
| 207R00000X Internal Medicine (Licence: NC 201400181) | |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2021-04-13 |