| NPI | 1679993042 |
|---|---|
| Former Name | SHANON TYRAH DEKALB |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA1036) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2023-11-10 |