| NPI | 1619263373 |
|---|---|
| Former Name | MAUREEN BRENNA FITZMAURICE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 60471517) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MR-1181) |
| 207Q00000X Family Medicine (Licence: ID M-11816) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2016-02-17 |