| NPI | 1407891187 |
|---|---|
| Former Name | LISA MARIE EDDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 41384) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 28123) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2017-02-02 |