| NPI | 1114129608 |
|---|---|
| Former Name | STEPHANIE ELAINE GRIESE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AK 239083) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101262085) |
| 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: MD D63821) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2025-07-21 |