| NPI | 1235408261 |
|---|---|
| Former Name | LOREN N GOODALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WV 01564) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2025-02-25 |