| NPI | 1972161503 |
|---|---|
| Other Name | SHANDA NICOLE PERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NC 0010-09102) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2022-07-27 |