NPI | 1821510173 |
---|---|
Former Name | ALYSSA HELEN STEPHENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA195071) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54621) |
Enumeration Date | 2017-07-07 |
Last Update Date | 2023-03-16 |