| NPI | 1245518281 |
|---|---|
| Former Name | SHANNON MICHELLE CRAVEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03058) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110005287) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2020-04-28 |