| NPI | 1912982455 |
|---|---|
| Former Name | MARIE LISA MANCAO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G161069) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 98109) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2021-02-08 |