| NPI | 1205494739 |
|---|---|
| Former Name | MEGHAN CLARE SHACKFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 58.031055) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 77643-21) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58.031055) | |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2023-02-27 |