| NPI | 1356367106 |
|---|---|
| Former Name | LISA ANN GUIDRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX N3700) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA MD026450) |
| 207N00000X Dermatology (Licence: LA 026450) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2022-02-17 |