| NPI | 1104246545 |
|---|---|
| Former Name | SHANNON RENEE WELLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME144400) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2025-01-10 |