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 |