| NPI | 1649718784 |
|---|---|
| Former Name | NICOLE LANE HOAG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 93066) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.014510) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2024-01-25 |