NPI | 1932686144 |
---|---|
Former Name | NICOLE JEAN STENQUIST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8622) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 55788) |
Enumeration Date | 2018-07-20 |
Last Update Date | 2022-06-28 |