| NPI | 1396705174 |
|---|---|
| Former Name | STEPHANIE ANNE SHEPARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005117) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA18335) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-01115) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2022-12-21 |