NPI | 1174014229 |
---|---|
Former Name | HEIDI ANNEMAE TUCKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A159931) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-05-24 |
Last Update Date | 2021-04-26 |