| NPI | 1235525098 |
|---|---|
| Former Name | ALLYSON NICHOLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.005882) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2019-10-24 |