| NPI | 1124149190 |
|---|---|
| Former Name | ELIZABETH JEAN THACKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-5492) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2015-02-03 |