| NPI | 1740418110 |
|---|---|
| Former Name | STACY A WILLIAMS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0004027) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WY TL529) |
| 363A00000X Physician Assistant (Licence: ME PA001171) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2021-06-21 |