| NPI | 1477978591 |
|---|---|
| Former Name | LISA JANE SHINKAROW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02042) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 4554) |
| 363AM0700X Physician Assistant, Medical (Licence: NJ MA056739) | |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2018-12-13 |