NPI | 1790051274 |
---|---|
Former Name | LISA GRIMALDI-PAWAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2013-0017) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5134) |
363A00000X Physician Assistant (Licence: CO 3371) | |
363A00000X Physician Assistant (Licence: UT 11578037-1206) | |
363A00000X Physician Assistant (Licence: CA 58871) | |
363AM0700X Physician Assistant, Medical (Licence: NM PA2013-0017) | |
Enumeration Date | 2012-03-28 |
Last Update Date | 2022-08-24 |