| NPI | 1902060387 |
|---|---|
| Former Name | SHANNA U GRANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015600) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA233) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2022-02-10 |