| NPI | 1083239537 |
|---|---|
| Former Name | SHELBY R LACEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02007102A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 02007102B) |
| 207R00000X Internal Medicine (Licence: TX BP10072222) | |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2023-07-10 |