| NPI | 1518113570 |
|---|---|
| Former Name | MARISSA LARA WEAKNECHT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS014928) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA 0012720) |
| 208M00000X Hospitalist (Licence: PA OS014928) | |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2012-01-11 |