NPI | 1629735303 |
---|---|
Former Name | STEPHANIE ANDREA O'CONNOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: IA R-12956) |
Additional Taxonomies | 171000000X Military Health Care Provider |
Enumeration Date | 2021-11-17 |
Last Update Date | 2023-07-11 |