| NPI | 1669748398 |
|---|---|
| Former Name | STEPHANIE ELIZABETH HAWK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME128505) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: FL ME128505) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2024-03-18 |