NPI | 1134457310 |
---|---|
Former Name | NICOLE ANNA MCBRIDE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0002842) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2842) |
Enumeration Date | 2009-11-25 |
Last Update Date | 2018-10-23 |