| NPI | 1336486752 |
|---|---|
| Former Name | JENNIFER LYNN LISCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08252) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9112291) |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2021-06-23 |