| NPI | 1538351739 |
|---|---|
| Former Name | STEPHANIE ALLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME126331) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH 13478) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2020-07-20 |