| NPI | 1750335493 |
|---|---|
| Former Name | LORRAINE NOREEN JARVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME130337) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 9401421) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2022-04-01 |