| 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: TX BP10072222) | 
| 207R00000X Internal Medicine (Licence: IN 02007102B) | |
| Enumeration Date | 2020-06-10 | 
| Last Update Date | 2024-08-19 |