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Individual
STEPHEN CRUZE
Active
Individual
STEPHEN CRUZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
7398126-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7398126-1206
STATE LICENSE
UT
Enumeration date
07/02/2009
Last updated
07/02/2009
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