| NPI | 1689145591 |
|---|---|
| Former Name | SHANNA GILBERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002597A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005816RX) |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2022-08-11 |