| NPI | 1386962694 |
|---|---|
| Former Name | JAIDA CELESTE BOURKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301116656) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 255059) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2019-05-21 |