| NPI | 1346595238 |
|---|---|
| Former Name | BETHANY ANN LISI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03594) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 0010-03594) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2021-02-16 |