| NPI | 1598715278 |
|---|---|
| Former Name | SHANNON PATRICK NANCE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 11128) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2006014624) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 8028A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 3654) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-12-28 |