| NPI | 1700373289 |
|---|---|
| Former Name | LISA MARIE DVORAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0001179) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LG-0001179) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC002264) | |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2024-01-30 |