| NPI | 1821104969 |
|---|---|
| Former Name | NICOLE COLLEEN FARLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 101241510) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2024-08-19 |