NPI | 1376138289 |
---|---|
Former Name | ABIGAIL COLLETT STEPHENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00684900) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-03-02 |
Last Update Date | 2022-12-02 |