NPI | 1962197343 |
---|---|
Former Name | LISA SOUL LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95030923) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 95201564) |
Enumeration Date | 2023-04-10 |
Last Update Date | 2024-07-19 |