| NPI | 1134779861 |
|---|---|
| Former Name | JACQULINE ANN SISTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA 95012716) |
| Enumeration Date | 2019-09-14 |
| Last Update Date | 2025-01-29 |