| NPI | 1295185494 |
|---|---|
| Former Name | SHELBY OLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: AZ D011566) |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: OH 3728) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2024-01-12 |