| NPI | 1891769469 |
|---|---|
| Former Name | NIKKI LEE TEEPLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0054902) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101057743) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2007-07-08 |