| NPI | 1962778779 |
|---|---|
| Former Name | STEPHANIE LISE MASTRANGELO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 51506) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 55730) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2020-12-10 |