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 | 2024-10-31 |