| NPI | 1215932702 |
|---|---|
| Former Name | SANDRA M SHELBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60467722) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601001357) |
| 363A00000X Physician Assistant (Licence: NC 0010-03212) | |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60467722) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2022-06-15 |