| NPI | 1316971427 |
|---|---|
| Former Name | LORI DAWN DEJERLD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 31011) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD466373) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2024-10-10 |