| NPI | 1427378090 |
|---|---|
| Former Name | NICOLE LICKING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO DR.0056501) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT013596) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: OR DO167009) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: PA OT013596) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: WY 13331A) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116023343) | |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2023-04-04 |