| NPI | 1386170462 |
|---|---|
| Former Name | NICHOLE CATHERINE BRENNAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13663) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07135) |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2021-08-09 |