| NPI | 1063444644 |
|---|---|
| Former Name | SHELLY MARIE WEISENFELD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 21225) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 21225) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2023-01-24 |