NPI | 1386164473 |
---|---|
Former Name | NICOLE ELIZABETH WOODEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME162196) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A167426) |
207Q00000X Family Medicine (Licence: TX T4291) | |
Enumeration Date | 2017-06-21 |
Last Update Date | 2023-10-24 |