NPI | 1013204007 |
---|---|
Former Name | KAREN ANNETTE STEPHENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005152RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07371) |
363AS0400X Physician Assistant, Surgical (Licence: TX PA07371) | |
Enumeration Date | 2011-06-29 |
Last Update Date | 2022-10-14 |