| NPI | 1104277540 |
|---|---|
| Former Name | KRISTA ANN LISKEVYCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95008971) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173674) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2018-09-07 |