NPI | 1265923536 |
---|---|
Former Name | SHANELLE RANAE HOLLOWAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2021-02487) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2021-02487) |
207R00000X Internal Medicine (Licence: MI 5101024187) | |
Enumeration Date | 2018-05-22 |
Last Update Date | 2023-03-07 |