| NPI | 1205130481 |
|---|---|
| Former Name | STEPHANIE JURDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA20783) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 20783) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2018-04-11 |