| NPI | 1902060759 |
|---|---|
| Former Name | SHAUNA M. MATLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 04201) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA DO-04201) |
| 207R00000X Internal Medicine (Licence: MN 106624) | |
| 207R00000X Internal Medicine (Licence: IA 4201) | |
| 207R00000X Internal Medicine (Licence: MI 5101017648) | |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2020-11-10 |