| NPI | 1780126920 |
|---|---|
| Former Name | LACEY NICOLE CHRISTIAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10002070A) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IN 10002070A) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2023-10-18 |