NPI | 1417305426 |
---|---|
Former Name | MELODY ANN NICHOLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WC0200X Registered Nurse Critical Care Medicine (Licence: MO 2008023092) |
Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: KS 14-120481-042) |
Enumeration Date | 2016-05-31 |
Last Update Date | 2016-05-31 |