NPI | 1609981968 |
---|---|
Former Name | STACY M BISHOP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS013789) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN DO2565) |
Enumeration Date | 2006-08-20 |
Last Update Date | 2023-10-24 |