NPI | 1962631309 |
---|---|
Former Name | STACY SCHEIBELHUT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MI 5101022138) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: OH 34.010682) |
207Q00000X Family Medicine (Licence: OH 34.010682) | |
Enumeration Date | 2009-07-07 |
Last Update Date | 2023-11-27 |