| NPI | 1730395609 |
|---|---|
| Former Name | JAIME DIANE NICHOLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 72434) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036123339) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2021-11-23 |