NPI | 1710569066 |
---|---|
Former Name | KATHARINE NICHOLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T8274) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10074691) |
Enumeration Date | 2021-04-26 |
Last Update Date | 2022-07-29 |