| NPI | 1891556809 |
|---|---|
| Former Name | SHANNON M. ROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA66047) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 031494) |
| Enumeration Date | 2024-01-17 |
| Last Update Date | 2025-05-15 |