NPI | 1396060224 |
---|---|
Former Name | SHANNON SHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: MI 4301104534) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D81623) |
207W00000X Ophthalmology (Licence: MI 4301104534) | |
Enumeration Date | 2010-04-04 |
Last Update Date | 2022-07-20 |