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Individual
SHELLY C. LALL
Active
Individual
SHELLY C. LALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2005027553
MO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
4301099915
MI
Other
Enumeration date
05/24/2006
Last updated
03/26/2014
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