NPI | 1538367362 |
---|---|
Former Name | SHANNON E YOUNG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60646227) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50001694) |
Enumeration Date | 2007-07-03 |
Last Update Date | 2024-07-05 |