| NPI | 1619237005 |
|---|---|
| Former Name | STEPHANIE ANN BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 57143) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 57143) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2020-10-27 |