| NPI | 1134243280 |
|---|---|
| Former Name | STACY LADAWN POND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 085001529) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085001529) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2019-04-25 |