| NPI | 1780805366 |
|---|---|
| Former Name | LISA STEPHANIE GALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 76051-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0065578) |
| 2080B0002X Pediatrics, Obesity Medicine (Licence: WI 76051-20) | |
| 2080H0002X (Licence: WI 76051-20) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2022-03-12 |