NPI | 1003124645 |
---|---|
Former Name | STEPHANIE N WRIGHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058057) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53573) |
363A00000X Physician Assistant (Licence: VA 0110003397) | |
Enumeration Date | 2010-09-16 |
Last Update Date | 2024-09-24 |