| NPI | 1477956191 |
|---|---|
| Former Name | NICOLE KOREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005513) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055-0031512) |
| 363A00000X Physician Assistant (Licence: AZ 5874) | |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2021-07-09 |