NPI | 1336124924 |
---|---|
Former Name | KAREN L SHAVER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 102021) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NC 102021) |
363AM0700X Physician Assistant, Medical | |
208000000X Pediatrics (Licence: NC 102021) | |
Enumeration Date | 2005-12-07 |
Last Update Date | 2024-08-08 |