| NPI | 1639582240 |
|---|---|
| Former Name | STEPHANIE ROSE CARVAJAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F303353-1) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2014-06-11 |