| NPI | 1215070933 |
|---|---|
| Former Name | STEPHANY MARIE NAMISNAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT003705) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-07-08 |