| NPI | 1487953675 |
|---|---|
| Former Name | SHANNON KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KY 50218) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VT 042.0012902) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2024-11-11 |