NPI | 1053669846 |
---|---|
Former Name | NICHOLE STEFFEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4610) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07950) |
363A00000X Physician Assistant (Licence: IL 085007047) | |
363A00000X Physician Assistant (Licence: CA PA51731) | |
Enumeration Date | 2012-08-27 |
Last Update Date | 2022-11-16 |