NPI | 1508893561 |
---|---|
Former Name | STEPHANIE P FAUST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MN 10118) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10118) |
Enumeration Date | 2006-06-27 |
Last Update Date | 2018-04-30 |