| NPI | 1922346964 |
|---|---|
| Former Name | STEPHANIE WAGNER DUMONT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME AP101001) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ME CNP101001) |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2015-10-22 |