| NPI | 1396484424 |
|---|---|
| Other Name | SHANE HENRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0102208061) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0116036918) |
| 207R00000X Internal Medicine (Licence: VA 0116036918) | |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2024-04-09 |