| NPI | 1538748975 |
|---|---|
| Former Name | SHANELL ANN SHOOP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 7776) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2025-01-29 |