| NPI | 1104483346 |
|---|---|
| Former Name | WILLIAM JEFFREY STURDAVANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301507579) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 2036243) |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2026-02-20 |