| NPI | 1992983548 |
|---|---|
| Other Name | STEPHANIE POWELL JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 50031) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 14936) |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2008-02-06 |