| NPI | 1609193523 |
|---|---|
| Former Name | LISA VANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2013-00571) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2010-05-02 |
| Last Update Date | 2025-03-13 |