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 |