NPI | 1033555370 |
---|---|
Former Name | AMY REBECCA RECKINGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MN 60403) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-05-14 |
Last Update Date | 2016-06-02 |