NPI | 1174816847 |
---|---|
Former Name | SHAUNA ASHLEY MIKEC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001002861) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 0010-02861) |
Enumeration Date | 2011-05-27 |
Last Update Date | 2020-10-25 |