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 |