NPI | 1922563493 |
---|---|
Former Name | SHANNON FRANCES ROOF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1115123) |
Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: TX 925668) |
Enumeration Date | 2019-02-08 |
Last Update Date | 2023-07-31 |