| NPI | 1598324105 |
|---|---|
| Former Name | KELLI HICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 13509689-1205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 250003) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2023-08-16 |