| NPI | 1225182637 |
|---|---|
| Former Name | SHANNON LYNETTE MILLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 42013) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 18706) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2008-00055) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-5160) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2016-08-10 |