NPI | 1265964381 |
---|---|
Former Name | JULIE REBECCA WADDLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 26550) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-03-29 |
Last Update Date | 2019-08-28 |