NPI | 1477820488 |
---|---|
Former Name | STEPHANIE JOANNE PELAEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106177) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106177) |
Enumeration Date | 2011-11-18 |
Last Update Date | 2023-10-13 |