| NPI | 1295012508 |
|---|---|
| Former Name | SHANNON CHRISTINA MALAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 4032) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 5036) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2017-11-29 |