| NPI | 1518306414 |
|---|---|
| Former Name | SHANNON KATHLEEN HARDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 29266) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE TEP#6973) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2022-07-21 |