NPI | 1528133329 |
---|---|
Former Name | STEPHANIE ANN OWENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106007) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04047) |
363A00000X Physician Assistant (Licence: LA A10617) | |
Enumeration Date | 2006-11-21 |
Last Update Date | 2015-10-13 |