| NPI | 1780398693 |
|---|---|
| Former Name | STEPHANIE SHAIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007763) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2025-04-10 |