| NPI | 1780967232 |
|---|---|
| Professional Name | SANDRA DENISE NICHOLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MD D60180) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D60180) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |