| NPI | 1093268765 |
|---|---|
| Former Name | LISA SHIRK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 2016023912) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 77340) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2017-11-30 |