| NPI | 1518260884 |
|---|---|
| Former Name | NICOLE BROWN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006690) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2019-02-21 |