| NPI | 1154386654 |
|---|---|
| Former Name | LISA BRANDT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9115253) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 004326) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2022-12-21 |