| NPI | 1366461162 |
|---|---|
| Former Name | LAURA MAE RIVERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 059950) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 059950) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2019-10-14 |