| NPI | 1144529496 |
|---|---|
| Former Name | SHANNON LEIGH BAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12417) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005843) |
| 363A00000X Physician Assistant (Licence: NH 0838) | |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2022-08-29 |