| NPI | 1013684059 |
|---|---|
| Former Name | SHANNON TAYLOR MCGINNIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062820) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2022-12-06 |