| NPI | 1265864268 |
|---|---|
| Former Name | NICOLE KATHOL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA56882) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW62470) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2021-06-29 |