| NPI | 1235562455 |
|---|---|
| Former Name | MICHELLE NICOLE NYMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008204) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA09873) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 016769) | |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2025-02-19 |