| NPI | 1194390443 |
|---|---|
| Other Name | MAGGIE LILLIAN FENNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2025-00230) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2025-00230) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2025-02-12 |