| NPI | 1639304736 |
|---|---|
| Former Name | STEPHANIE MARY JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 60446) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2023-10-26 |