| NPI | 1417679895 |
|---|---|
| Former Name | NICOLE DINAY KAKOULIAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-81525-122) |
| Enumeration Date | 2022-09-13 |
| Last Update Date | 2024-01-11 |