NPI | 1427222355 |
---|---|
Former Name | NICOLE JEANETTE MECHALY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C03106) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C03106) |
Enumeration Date | 2008-04-22 |
Last Update Date | 2010-08-03 |