| NPI | 1023246626 |
|---|---|
| Former Name | SHELLY LOUISE STEPHENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 69510) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 3708) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2014-05-19 |