NPI | 1881039691 |
---|---|
Former Name | HEATHER A SHAWLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: PA SP012860) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP012860) |
Enumeration Date | 2013-05-07 |
Last Update Date | 2021-05-26 |