NPI | 1235314840 |
---|---|
Former Name | SHANNON FITZGERALD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 14348) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 0050-03854) |
Enumeration Date | 2008-01-02 |
Last Update Date | 2016-11-17 |