NPI | 1629337902 |
---|---|
Former Name | SHANNON N RECORDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA1327) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NH 0900) |
Enumeration Date | 2012-05-08 |
Last Update Date | 2023-11-13 |