| NPI | 1407349384 |
|---|---|
| Other Name | SHAYNA FASANELLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9112616) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601008742) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2020-01-28 |