| NPI | 1013060664 |
|---|---|
| Former Name | LISA M DONNELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 011259) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011259) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2016-12-29 |