| NPI | 1336776830 |
|---|---|
| Former Name | JORDANA BROOKE HERR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME151741) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 171000000X Military Health Care Provider (Licence: FL ME151741) | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-08-20 |