| NPI | 1063994424 |
|---|---|
| Former Name | KATELYN ELIZABETH THICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MI 5601008800) |
| Enumeration Date | 2018-09-02 |
| Last Update Date | 2021-07-13 |