| NPI | 1194793455 |
|---|---|
| Former Name | MARITA NICKENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D50332) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD19889) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2021-06-26 |