| NPI | 1487077723 |
|---|---|
| Former Name | LISA MARIE ROUGRAFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2017-04-07 |