| NPI | 1124231154 |
|---|---|
| Former Name | SHANNON MAUREEN CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.013026) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 34.009495) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2017-09-21 |