| NPI | 1386008779 |
|---|---|
| Former Name | NICOLE KRISTEN AVERSA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E5708) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2020-08-21 |