NPI | 1548852783 |
---|---|
Former Name | NICOLE KAHEALANI CASADONA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3873) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 3873) |
Enumeration Date | 2021-02-09 |
Last Update Date | 2023-06-26 |