| NPI | 1457146805 |
|---|---|
| Former Name | MILADA KEOTIDA VANNARATH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 101714851) |
| Enumeration Date | 2025-04-14 |
| Last Update Date | 2025-07-08 |