| NPI | 1447575428 |
|---|---|
| Other Name | SHANNON DAWN DIETZMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OR MD166551) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A140657) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2022-01-10 |