Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A131627 | CA |
Y | 208600000X | Surgeon | A131627 | CA |
N | 2086S0102X | Surgical Critical Care | A131627 | CA |
NPI | 1255861787 |
---|---|
Provider Name | Dr. Lisa Marie Knowlton |
First Address | Palo Alto, CA 94304-2113 |
Second Address | Stanford, CA 94305-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2017 |
Last Update Date | 17/03/2018 |