| NPI | 1982951687 |
|---|---|
| Former Name | ANDREA LEE THOMAS(BIRTH)RIVERS(FIRST MARRIAGE) |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME153060) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD.33456) |
| 207Q00000X Family Medicine (Licence: WA MD60485834) | |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2022-08-12 |