| NPI | 1558777649 |
|---|---|
| Former Name | STEPHANIE GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL OS16128) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL Uo4046) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2020-11-23 |