| NPI | 1336371525 |
|---|---|
| Former Name | NICOLE DESIMONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0102203996) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2020-04156) |
| 208600000X Surgery (Licence: PA 0T013281) | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2024-06-28 |