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 |