| NPI | 1700827375 |
|---|---|
| Former Name | KERRY PAIGE WIDDERSHEIM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 207638) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NY 207638) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2022-10-18 |