| NPI | 1912235375 |
|---|---|
| Former Name | STEPHANIE ELIZABETH HOOGERHYDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA055098) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 01447) |
| 363A00000X Physician Assistant (Licence: PA MA055098) | |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2015-09-22 |