| NPI | 1689806663 |
|---|---|
| Former Name | STEPHANIE ALYSSA MULLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: ID 109240) |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2024-04-01 |