| NPI | 1326148404 |
|---|---|
| Former Name | LISA PHILLIANS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011299) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011299-1) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2022-08-05 |