| NPI | 1487607453 | 
|---|---|
| Former Name | STEPHANIE ANN GESINK | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 15-00780) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2004029286) | 
| Enumeration Date | 2006-05-18 | 
| Last Update Date | 2014-10-24 |