| NPI | 1780812735 |
|---|---|
| Former Name | LISA NICOLE FREDIAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ME MD24235) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 253205) |
| 207W00000X Ophthalmology (Licence: MI 4301094262) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2023-10-12 |