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 |