NPI | 1578997698 |
---|---|
Former Name | ALLISON SHANNON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5777) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 5777) |
Enumeration Date | 2013-08-26 |
Last Update Date | 2024-05-23 |