| NPI | 1699149856 |
|---|---|
| Former Name | LISA ROACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 20594) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000020594) |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2024-04-24 |