| NPI | 1114383775 |
|---|---|
| Other Name | COLLEEN SHANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MT217671) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD M-650-122-792-658) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2019-06-03 |