| NPI | 1316501067 |
|---|---|
| Former Name | STEPHANIE SHOOP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.014844) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 58.030598) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2022-01-24 |