| NPI | 1184915407 |
|---|---|
| Former Name | SHAYNE THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 146174) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 260709) |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2017-05-12 |