| NPI | 1376675876 |
|---|---|
| Former Name | LORI ELIZABETH NICKEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 0533758) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R3667) |
| Enumeration Date | 2007-03-10 |
| Last Update Date | 2017-10-10 |