NPI | 1558454066 |
---|---|
Former Name | LORI JANE WILLIAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 58) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 58 (PA-C)) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2017-10-11 |