| NPI | 1356716161 |
|---|---|
| Former Name | NICOLE GEORGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5603) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 019390) |
| 363A00000X Physician Assistant (Licence: NY 019390) | |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2024-07-18 |