NPI | 1033550926 |
---|---|
Former Name | STEPHANIE CATHERINE PRICE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008137) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C05126) |
Enumeration Date | 2013-07-09 |
Last Update Date | 2017-05-03 |