NPI | 1487886875 |
---|---|
Former Name | LISA BETH LAVIKOFF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA09365800) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 260218) |
Enumeration Date | 2009-08-18 |
Last Update Date | 2013-11-01 |