| NPI | 1902212426 |
|---|---|
| Former Name | SHELLY R ALDRICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WI 3333-23) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2022-01-21 |