| NPI | 1578976155 |
|---|---|
| Former Name | LISA MARIE NEVERMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA MD-44255) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: IA MD-44255) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2018-09-05 |