| NPI | 1518129220 |
|---|---|
| Former Name | MARY ELIZABETH KENNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-01614) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT012488) |
| 207Q00000X Family Medicine (Licence: MD H72623) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2020-04-28 |