| NPI | 1063836229 |
|---|---|
| Former Name | LISA RUIDERA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 24172357) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 23624) |
| Enumeration Date | 2014-02-08 |
| Last Update Date | 2022-04-19 |