Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 78182 | GA |
NPI | 1225455793 |
---|---|
Provider Name | Lisa Lima |
First Address | Atlanta, GA 30322-1060 |
Second Address | Atlanta, GA 30322-1060 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2014 |
Last Update Date | 25/06/2021 |