| NPI | 1508245689 |
|---|---|
| Former Name | SHANNON CALDWELL CLEMONS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: LA 323811) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 039.146919) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2024-10-08 |