| NPI | 1053715326 |
|---|---|
| Former Name | LISA MARIE RIESTERER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201392419NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201392419NP-PP) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2021-03-22 |