| NPI | 1548897119 |
|---|---|
| Former Name | AUDREY JEAN NICHOLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A182796) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA PTL3653) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2023-06-13 |