| NPI | 1093414534 |
|---|---|
| Former Name | NIKKI LAUDERBACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V4138) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX V4138) |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2026-05-12 |