| NPI | 1053931147 |
|---|---|
| Former Name | BAILEY NICOLE WATERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-52770) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA R-11946) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4351052042) | |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2024-06-27 |