| NPI | 1588020002 |
|---|---|
| Former Name | STEPHANIE ANN GOLUB |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: KS 15-01867) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: MO 2016000760) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2022-10-03 |