| NPI | 1316173081 |
|---|---|
| Former Name | CHANEL SHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 201201150) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT195096) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2016-05-20 |