| NPI | 1649234139 |
|---|---|
| Former Name | CAROL GRACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G84833) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA11155800) |
| 207Q00000X Family Medicine (Licence: AL 00025976) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2025-06-17 |