| NPI | 1669882106 |
|---|---|
| Former Name | LISA BYRNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2017027623) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 78393) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 5756-33) | |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2018-12-12 |