| NPI | 1881162402 |
|---|---|
| Former Name | LISA JEANNE ISTORICO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: FL ME53030) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL 53030) |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2020-10-27 |