| NPI | 1033397450 |
|---|---|
| Other Name | LISA A NICHOLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60125666) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0002085) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2014-03-13 |