NPI | 1568826857 |
---|---|
Former Name | SHANNON ARCHABAL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0059858) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-04-12 |
Last Update Date | 2021-12-15 |