| NPI | 1023518529 |
|---|---|
| Former Name | LACEY NICOLE DENNIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AL DO.2577) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 2577) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2024-08-13 |