| NPI | 1538370846 |
|---|---|
| Former Name | SHA-RON JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01076732A) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57010730) |
| 2086S0127X Surgery, Trauma Surgery (Licence: OH 35 123453) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2016-09-13 |