NPI | 1396085981 |
---|---|
Former Name | JACQUELINE MICHELE PILCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 85496) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 3324) |
Enumeration Date | 2013-02-19 |
Last Update Date | 2024-11-05 |