NPI | 1669413738 |
---|---|
Former Name | DOLORES KATHLEEN SPAVIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME76211) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME0076211) |
Enumeration Date | 2006-06-09 |
Last Update Date | 2011-10-24 |