| NPI | 1215554324 |
|---|---|
| Former Name | LISA MICHELLE VACA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R38962) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ND R38962) |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2023-10-09 |