NPI | 1477899441 |
---|---|
Former Name | SHELLY RICHARDS BELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2998) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03974) |
Enumeration Date | 2012-12-20 |
Last Update Date | 2024-02-01 |