NPI | 1033560545 |
---|---|
Former Name | ASHLEY HICKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 82780) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-06-27 |
Last Update Date | 2023-02-07 |