| NPI | 1811148505 |
|---|---|
| Former Name | STEPHANIE KRICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053616) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002308) |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2022-10-05 |