| NPI | 1487997193 |
|---|---|
| Former Name | STEPHANIE DIANE MARKS |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 90763) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 73248) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2014-03-10 |