| NPI | 1619210648 |
|---|---|
| Former Name | STACY LEE O'NEILL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 283301) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2018-03-17 |