| NPI | 1598798316 |
|---|---|
| Former Name | LISA LEE GUSHWA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 11969) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 34251) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2025-04-15 |