| NPI | 1134610280 |
|---|---|
| Former Name | REBECCA LYSIAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2321745) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2321745) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2023-07-28 |