| NPI | 1760805329 | 
|---|---|
| Former Name | SAURA SHANAKI | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OK 2372)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2372)  | 
| 363AM0700X Physician Assistant, Medical (Licence: OK 2372)  | |
| Enumeration Date | 2014-01-31 | 
| Last Update Date | 2019-04-08 |