| NPI | 1053644658 |
|---|---|
| Former Name | SHANNON ROSE SWEENEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA3869) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2023-11-16 |