| NPI | 1952148165 |
|---|---|
| Former Name | EMMA LACY MORTIMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-07-15 |