| NPI | 1487887964 |
|---|---|
| Former Name | SHANNON K LEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 3198) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1325) |
| 363A00000X Physician Assistant (Licence: MN 10656) | |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2019-10-24 |