| NPI | 1548245012 |
|---|---|
| Former Name | SHANNON J KOWAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 40982) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q5925) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2019-10-01 |