NPI | 1669591079 |
---|---|
Former Name | ELISA B PICKEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301082194) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301082194) |
Enumeration Date | 2007-03-28 |
Last Update Date | 2024-06-25 |