| NPI | 1245965144 |
|---|---|
| Former Name | SHANNON E GIBSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 372600000X Adult Companion (Licence: FL 238705) |
| Additional Taxonomies | 376J00000X Homemaker (Licence: FL 238705) |
| Enumeration Date | 2022-07-24 |
| Last Update Date | 2022-07-25 |