| NPI | 1043771405 |
|---|---|
| Former Name | LISA MICHELLE PETRUNCIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC MMD.89586) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 70510) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2024-06-20 |