NPI | 1295872380 |
---|---|
Former Name | SHELLEY ANN DUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052627) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA052627) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2024-06-19 |