NPI | 1801363411 |
---|---|
Former Name | LISA ANN THUMM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11000002) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 1000002) |
Enumeration Date | 2018-11-01 |
Last Update Date | 2023-05-09 |