| NPI | 1417343930 |
|---|---|
| Former Name | NICHOLE LYNN FOUST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA OS019207) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2018-05-22 |