| NPI | 1578848305 |
|---|---|
| Former Name | LISA M LYCKSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 9646) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-015864) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2021-07-29 |