| NPI | 1629139340 |
|---|---|
| Professional Name | ILISA DAWN WALLACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 176452) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 176452) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2016-02-02 |