| NPI | 1770560161 |
|---|---|
| Former Name | SHANNAN LEE BROOKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 1162) |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 1162) |
| 2086S0129X Surgery, Vascular Surgery (Licence: OK 1162) | |
| 363AM0700X Physician Assistant, Medical (Licence: OK 1162) | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2016-02-03 |