| NPI | 1265687198 |
|---|---|
| Former Name | STACEY MARIE CORYELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C2-0023949) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB08910400) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2024-05-23 |