| NPI | 1598018749 |
|---|---|
| Former Name | NICOLE B DALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001461A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1894) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2021-06-17 |