| NPI | 1184773939 |
|---|---|
| Former Name | SHELLEY V. STREET |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: GA 069155) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 069155) |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: GA 069155) | |
| 208000000X Pediatrics (Licence: GA 069155) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-09-15 |