| NPI | 1205316775 |
|---|---|
| Former Name | SHANNON A AULT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: IA K117072) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA K117072) |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2018-08-15 |