| NPI | 1992473813 |
|---|---|
| Former Name | LISANGI FERNANDEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8547) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 8547) |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2022-11-30 |