| NPI | 1497792485 |
|---|---|
| Former Name | LISA MONICA MALBURG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704173236) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704173236) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2018-12-03 |