| NPI | 1073256616 |
|---|---|
| Professional Name | SHANNON GREEN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2024-12-24 |