| NPI | 1548714033 |
|---|---|
| Former Name | CHI SHATALOV |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063711) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06654) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2022-10-31 |