NPI | 1568774834 |
---|---|
Former Name | SHANNON SEANA RICKNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q0551) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT198330) |
Enumeration Date | 2010-07-02 |
Last Update Date | 2014-09-16 |