NPI | 1811300247 |
---|---|
Former Name | ELIZABETH LAPHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02005803A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 3053) |
Enumeration Date | 2014-06-03 |
Last Update Date | 2020-12-01 |