| NPI | 1003283573 |
|---|---|
| Former Name | CLARISSA ANN SHELLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX 15-105) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2015-08-31 |