NPI | 1730663287 |
---|---|
Former Name | LISA S ISRAEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: RI PA01080) |
Enumeration Date | 2018-09-20 |
Last Update Date | 2020-03-25 |