NPI | 1053648451 |
---|---|
Former Name | LISA MARIE PAULEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05101) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2009-11-06 |
Last Update Date | 2024-03-20 |