| NPI | 1487641536 |
|---|---|
| Other Name | SHAWNA C RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04131) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA04131) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2022-02-24 |