| NPI | 1437936838 |
|---|---|
| Former Name | COURTNEY AMBER NICHOLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-11-20 |