NPI | 1265668693 |
---|---|
Former Name | STEPHANIE ANN RASBURY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104915) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9104915) |
363AS0400X Physician Assistant, Surgical (Licence: FL PA9104915) | |
Enumeration Date | 2009-05-29 |
Last Update Date | 2014-06-24 |