NPI | 1831851070 |
---|---|
Former Name | LISA MARIA PHILLIPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 11220-33) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 11220-33) |
Enumeration Date | 2021-10-05 |
Last Update Date | 2025-02-10 |