NPI | 1871154617 |
---|---|
Former Name | SHANNON CHRISTINE GINTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09159) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-09159) |
Enumeration Date | 2019-06-24 |
Last Update Date | 2023-12-05 |