| NPI | 1952643678 |
|---|---|
| Former Name | LISA MARIE HIMIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME126945) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 40806) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2022-07-21 |