| NPI | 1356490114 |
|---|---|
| Former Name | STACEY BURPEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR DO150983) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 229628) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2013-07-09 |