| NPI | 1659378727 |
|---|---|
| Former Name | STACY L HANGEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OH 032526) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH RN-293715) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2007-07-08 |