| NPI | 1235192048 |
|---|---|
| Former Name | MARIE M SHOCKLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002202) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-002202) |
| 363AS0400X Physician Assistant, Surgical (Licence: VA 0110-002202) | |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2023-03-21 |