NPI | 1679976732 |
---|---|
Former Name | STEFANIE A GLIDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 075480) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005343) |
Enumeration Date | 2014-10-03 |
Last Update Date | 2021-04-07 |