| NPI | 1558656132 |
|---|---|
| Former Name | JACQUELINE NICHOLS EDWARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101253391) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101253391) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2023-02-23 |