| NPI | 1871754499 |
|---|---|
| Former Name | STEPHANIE BYNUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D74973) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 11014288A) |
| 207R00000X Internal Medicine (Licence: IN 01069672A) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2017-02-02 |