| NPI | 1790149763 |
|---|---|
| Former Name | SHANNON KATHLEEN QUIRK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 70147) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WI 6600-851) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2022-10-07 |