NPI | 1912163825 |
---|---|
Former Name | STEPHANIE JEANE FESSLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: GA 65105) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-052596) |
Enumeration Date | 2008-07-30 |
Last Update Date | 2023-03-03 |