| NPI | 1609160548 |
|---|---|
| Former Name | STEPHANIE LAEL ETTELMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IA MD-43586) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IA R-9125) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2016-06-25 |