| NPI | 1740266501 |
|---|---|
| Former Name | SHANNON RENAE LUCENTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 34.008522) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH BL9255058) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2011-01-18 |