| NPI | 1902972441 |
|---|---|
| Former Name | SHANNON RENEE WRIGHT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KY 41396) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME 97022) |
| 207N00000X Dermatology (Licence: TN 45270) | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2014-07-02 |