| NPI | 1871603902 |
|---|---|
| Former Name | SHANNON C MILLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61086741) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058013) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-04-29 |