| NPI | 1346756517 |
|---|---|
| Former Name | NICOLE LYNN TROUT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: KY SA312) |
| Enumeration Date | 2017-12-23 |
| Last Update Date | 2017-12-23 |