| NPI | 1265436687 |
|---|---|
| Former Name | SHANNON LEE CASIDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00033219) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 51138020) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2020-11-11 |