| NPI | 1215913702 |
|---|---|
| Former Name | MARY MARGARET MCGRANAHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME1282515) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101237031) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2024-02-08 |