| NPI | 1033498738 |
|---|---|
| Former Name | LISA CATHERINE JORDAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 31304) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN014283) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2016-02-29 |