| NPI | 1720202732 |
|---|---|
| Former Name | SHANNON M MANSER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-03936) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA IA001062) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA R8200) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2015-04-07 |