NPI | 1407122880 |
---|---|
Former Name | NICOLE JANETTE SARDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5069) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.790) |
363A00000X Physician Assistant (Licence: CA 54408) | |
Enumeration Date | 2012-03-29 |
Last Update Date | 2023-11-14 |