| NPI | 1780118331 |
|---|---|
| Former Name | STEPHANIE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 94-11088) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND RL15185) |
| 207R00000X Internal Medicine (Licence: ND 16786) | |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2022-06-28 |