| NPI | 1962996876 |
|---|---|
| Former Name | ALEXANDRA DIANE PITAWANAKWAT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.145057) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351044680) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2022-06-23 |