| NPI | 1518300607 |
|---|---|
| Former Name | STEPHANIE DENISE OLDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 52077) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 52077) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2022-05-08 |