| NPI | 1760832117 |
|---|---|
| Former Name | LACEY AVILA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX T3133) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MA 1017531) |
| 2086S0127X Surgery, Trauma Surgery (Licence: CO DR.0068531) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NC 2026-00086) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: VA 0101286193) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MO 2024044388) | |
| 208600000X Surgery (Licence: FL TRN23830) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL ME148659) | |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2026-03-18 |