| NPI | 1023008000 |
|---|---|
| Former Name | LISA DIANE COLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA07918100) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0080347) |
| 208D00000X General Practice (Licence: DE C10009764) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2023-08-31 |