NPI | 1780650689 |
---|---|
Former Name | STEPHANIE A. WEBER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031322) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052227) |
Enumeration Date | 2006-02-28 |
Last Update Date | 2017-01-12 |