| NPI | 1538183892 |
|---|---|
| Former Name | LISA MICHELLE SKULTETY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: PA OS012226) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-01-04 |