| NPI | 1578513537 |
|---|---|
| Former Name | AMY C LISTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 51179) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-31041) |
| 207Q00000X Family Medicine (Licence: MO 2022007355) | |
| 207Q00000X Family Medicine (Licence: TX T7639) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-03-07 |