| NPI | 1154474369 |
|---|---|
| Former Name | NICHOLE KRISTINE GREULICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DC PA031121) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 010809) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2015-06-05 |