NPI | 1578878740 |
---|---|
Former Name | NICOLE ELIZABETH KERN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010578) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002420) |
363A00000X Physician Assistant (Licence: TX PA13285) | |
363AM0700X Physician Assistant, Medical (Licence: CT 002420) | |
Enumeration Date | 2010-08-12 |
Last Update Date | 2025-03-06 |