| NPI | 1114476140 |
|---|---|
| Former Name | LISA RUTH COCCO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601008938) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 5601008938) |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA53731) | |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2021-04-29 |