NPI | 1336284660 |
---|---|
Former Name | JENNIFER L LISKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 11002903) |
Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: WI 2279) |
Enumeration Date | 2007-02-21 |
Last Update Date | 2019-11-18 |