| NPI | 1215593041 |
|---|---|
| Former Name | SHANA ELIZABETH SANDFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME155616) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2022-10-06 |