| NPI | 1366101784 |
|---|---|
| Former Name | SHAUNDA LYN LAMPHERE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: WY 206758) |
| Enumeration Date | 2021-12-13 |
| Last Update Date | 2022-01-06 |