NPI | 1245684489 |
---|---|
Former Name | LISA ANN MAZZOCUT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OR DO211433) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-04-13 |
Last Update Date | 2023-01-17 |