| NPI | 1790193423 |
|---|---|
| Former Name | DEANNA BARBARA SHIPPEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085005106) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005106) |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2018-07-26 |