| NPI | 1487088241 |
|---|---|
| Former Name | STEPHANIE SAAL AVILES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 5910) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA-4817) |
| 363A00000X Physician Assistant (Licence: MA PA4817) | |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2022-12-07 |