| NPI | 1588062145 |
|---|---|
| Former Name | JOANNA JANE NICHOLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA62986) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA09577) |
| 363A00000X Physician Assistant (Licence: TX PA09577) | |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2024-02-20 |