| NPI | 1871087577 |
|---|---|
| Former Name | LISA ANNE VITELLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301115202) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4351028274) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2021-05-29 |