| NPI | 1689023079 |
|---|---|
| Former Name | MARIE RENEE GEORGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS018986) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT016961) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2019-08-12 |