NPI | 1972746444 |
---|---|
Former Name | SHANNA RENEE LASSITER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2014006556) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX P1800) |
Enumeration Date | 2009-04-14 |
Last Update Date | 2019-04-17 |