| NPI | 1568774834 |
|---|---|
| Former Name | SHANNON SEANA RICKNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q0551) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT198330) |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2014-09-16 |