| NPI | 1790290716 |
|---|---|
| Former Name | LISA MICHELLE HANSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12637) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2021-12-07 |