NPI | 1548374663 |
---|---|
Former Name | LANA A. DOXTATER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME120852) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 50091-20) |
Enumeration Date | 2006-08-18 |
Last Update Date | 2020-09-10 |