NPI | 1740358605 |
---|---|
Former Name | LE'ANNA SHANNON STJOHN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-889) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA17603) |
Enumeration Date | 2006-11-30 |
Last Update Date | 2019-02-06 |