| NPI | 1053603704 |
|---|---|
| Former Name | TERISA CHANTELE STOVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA21540) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA21540) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2012-04-04 |