| NPI | 1861838559 |
|---|---|
| Former Name | SHELLEY HAGAN BRIDGFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2015020992) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2022-01-17 |