NPI | 1174945844 |
---|---|
Former Name | STEPHANIE L. PANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 3234-23) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3234-23) |
Enumeration Date | 2014-01-14 |
Last Update Date | 2019-10-16 |