| NPI | 1760601371 |
|---|---|
| Former Name | STEPHANIE KATHRYN BEIDLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: TX P2194) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2005-01643) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2015-12-02 |