| NPI | 1821081746 |
|---|---|
| Former Name | KIM SHANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 463192-1) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 463192) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2018-12-28 |