| NPI | 1831121664 |
|---|---|
| Former Name | PATRICIA ELIZABETH TARANTULA SHAMBAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9101342) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2009-06-15 |