| NPI | 1538583786 |
|---|---|
| Former Name | SHANNON HENDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2865M2000X Military Hospital, Military General Acute Care Hospital (Licence: FL RN9359274) |
| Enumeration Date | 2014-02-08 |
| Last Update Date | 2014-02-08 |