| NPI | 1831123793 |
|---|---|
| Former Name | LISA M DIAMOND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 187547) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 2355) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-03-23 |