| NPI | 1093951857 |
|---|---|
| Former Name | SHANNON ELIZABETH WHITAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD440832) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT191101) |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2016-07-18 |