NPI | 1669609442 |
---|---|
Former Name | DOLLY PENN WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: GA 81812) |
Additional Taxonomies | 208D00000X General Practice (Licence: GA 81812) |
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MD D81335) | |
Enumeration Date | 2009-06-18 |
Last Update Date | 2025-02-25 |