| 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 |