| NPI | 1639751142 |
|---|---|
| Former Name | SHANNON OLIVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007435) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2024-03-12 |