NPI | 1396060216 |
---|---|
Former Name | NICOLE ALYSSA MAH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0102517) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 50656) |
Enumeration Date | 2010-04-03 |
Last Update Date | 2025-09-12 |