NPI | 1902497597 |
---|---|
Former Name | LACCEY LOUISE LISKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A162720) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A162720) |
Enumeration Date | 2021-01-27 |
Last Update Date | 2022-03-04 |