NPI | 1194751792 |
---|---|
Former Name | STEPHANIE KIRKPATRICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 005416) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT 9103434) |
Enumeration Date | 2006-06-24 |
Last Update Date | 2010-07-26 |