| NPI | 1598140352 |
|---|---|
| Former Name | SHANNON MARIE BROSEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP015199) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN630765) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2018-08-01 |