| NPI | 1235571217 |
|---|---|
| Former Name | LISA RACHEL VADIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R 160181 9) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP 60434868) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2014-02-13 |