| NPI | 1215174990 |
|---|---|
| Former Name | LISA ANN VIGNOLA JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 081637) |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2009-01-16 |