| NPI | 1477102382 |
|---|---|
| Former Name | STEPHANIE LYNN KOSKAMP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MO 2019006409) |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2020-12-15 |