NPI | 1124438759 |
---|---|
Former Name | SHANNON DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: SC 82202) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC DO034666) |
Enumeration Date | 2014-05-05 |
Last Update Date | 2019-08-29 |