| NPI | 1891784914 |
|---|---|
| Former Name | SHAWNA NIKIA VERDUN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: LA 146) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.200050) |
| 363AM0700X Physician Assistant, Medical (Licence: LA 200050) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2022-06-22 |