| NPI | 1518126804 |
|---|---|
| Former Name | JOHANNA LIZAOLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA19497) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA 19497) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2012-11-15 |