| NPI | 1003893108 |
|---|---|
| Former Name | LORI A DOREN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA620) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA-620) |
| 363A00000X Physician Assistant (Licence: NH 0859) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2015-01-08 |