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 |