NPI | 1942762802 |
---|---|
Former Name | VICTORIA STEPHENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 11266) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-04-01 |
Last Update Date | 2019-06-25 |