| NPI | 1215455001 |
|---|---|
| Former Name | SHELBY GREENBAUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2019-05-14 |