NPI | 1205085321 |
---|---|
Former Name | LISA LAURA GUIDA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00107400) |
Enumeration Date | 2008-09-12 |
Last Update Date | 2024-03-13 |