| NPI | 1841821113 |
|---|---|
| Former Name | SHANNON REBECCA PULLIAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14832) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2023-11-14 |