| NPI | 1548204472 |
|---|---|
| Former Name | LISA LOUISE BELANGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 14183) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0003529) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2022-10-17 |