| NPI | 1083004840 |
|---|---|
| Former Name | STEPHANIE CHINCHEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-01914) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 314836-01) |
| 207Q00000X Family Medicine (Licence: NE 29452) | |
| 207Q00000X Family Medicine (Licence: ID M-16392) | |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2022-11-17 |