NPI | 1285871590 |
---|---|
Former Name | STEPHANIE LYNN RICHENDRFER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053550) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA053550) |
Enumeration Date | 2009-01-08 |
Last Update Date | 2021-01-16 |