| NPI | 1871141929 |
|---|---|
| Former Name | STEPHANIE DAWN BAKA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 9443) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 9443-33) |
| Enumeration Date | 2019-09-02 |
| Last Update Date | 2019-10-02 |