NPI | 1407829963 |
---|---|
Former Name | DEBRA MARIE STONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA051496) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005118) |
363AM0700X Physician Assistant, Medical (Licence: PA MA051496) | |
Enumeration Date | 2006-02-07 |
Last Update Date | 2024-08-21 |