NPI | 1780607606 |
---|---|
Former Name | STACY LYNN PEARSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD205244) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01066923A) |
Enumeration Date | 2006-07-25 |
Last Update Date | 2021-07-19 |