NPI | 1437562089 |
---|---|
Former Name | KRISTIN SICA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD465631) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE 0012862) |
Enumeration Date | 2014-06-10 |
Last Update Date | 2022-11-14 |