| NPI | 1598337982 |
|---|---|
| Former Name | CARSON LEIGH SHANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00205266) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE61187483) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2023-09-12 |