| NPI | 1528106176 |
|---|---|
| Former Name | LISA JASE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24962) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 4968) |
| 122300000X Dentist (Licence: TX 24962) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2010-05-11 |