| NPI | 1306053715 |
|---|---|
| Former Name | STEPHLANIE ALICE SHAFER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: WV 1175279) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-09 |