| 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 |