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 |