| NPI | 1710372511 |
|---|---|
| Former Name | SHANNON ELIZABETH BROCKMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL TRN34833) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: VA 0101261265) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2023-03-14 |