NPI | 1588861421 |
---|---|
Former Name | STACY LYNN PINTAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 1142) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 4247) |
Enumeration Date | 2007-07-02 |
Last Update Date | 2017-11-01 |