| NPI | 1265758395 |
|---|---|
| Former Name | SHANNON WEBER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2010018560) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 135238) |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2012-09-12 |