| NPI | 1164901609 |
|---|---|
| Former Name | STEFFANIE CAROL VAVRA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343411) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 659830) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2020-05-22 |