| NPI | 1124478870 |
|---|---|
| Former Name | LAURA LYNN PAIVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60975529) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2021-05-05 |