| NPI | 1508055146 |
|---|---|
| Former Name | LISA MAUREEN WALASKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA053125) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA002276) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2023-07-21 |