| NPI | 1003254012 |
|---|---|
| Former Name | KATHERINE LILLIAN STITELY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME136423) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 076953) |
| 207Q00000X Family Medicine (Licence: SC 35648) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2019-11-06 |