NPI | 1043674666 |
---|---|
Former Name | LISA MIDBOE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 12233984-1204) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VT 031.0129166) |
Enumeration Date | 2016-04-09 |
Last Update Date | 2023-04-13 |