| NPI | 1477173326 |
|---|---|
| Former Name | LISA KATE SUSSMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: VA 101278362) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2024-03-21 |