| NPI | 1043388796 |
|---|---|
| Former Name | NICOLE M JAHN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2347) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00166100) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2017-03-13 |