| NPI | 1700990827 |
|---|---|
| Former Name | LEAH LANE SHUTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 30653) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200600241) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2023-03-07 |