| NPI | 1346768934 | 
|---|---|
| Former Name | LISA PATE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95006820) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 549679) | 
| 364S00000X Clinical Nurse Specialist (Licence: CA 4607) | |
| Enumeration Date | 2017-09-02 | 
| Last Update Date | 2017-09-02 |