NPI | 1427571611 |
---|---|
Former Name | LORA ELIZABETH DOEBLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00639100) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059049) |
Enumeration Date | 2017-07-20 |
Last Update Date | 2023-04-18 |