| NPI | 1255659637 |
|---|---|
| Former Name | SHANNON MARY FULLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 271464) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 271464) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2023-06-29 |