| NPI | 1003927112 | 
|---|---|
| Former Name | LISA SANTOS KRESNICKA | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: FL ME133729)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL Me96905)  | 
| 208000000X Pediatrics (Licence: KS 04-33344)  | |
| 208000000X Pediatrics (Licence: MO 2008021141)  | |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: FL ME133729)  | |
| Enumeration Date | 2006-08-31 | 
| Last Update Date | 2019-04-26 |