| NPI | 1174661011 |
|---|---|
| Former Name | LISA LYA LOGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MT 11801) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: ME 1440) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2018-08-15 |