| NPI | 1639390081 |
|---|---|
| Former Name | SHAWNNA J GREGG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 006202) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006202) |
| 363AS0400X Physician Assistant, Surgical (Licence: TN PA0000000778) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2021-02-24 |