| NPI | 1598058331 |
|---|---|
| Former Name | COURTNEY NICOLE RICCI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2021-0032) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004740) |
| 363AM0700X Physician Assistant, Medical (Licence: RI PA00792) | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2021-05-19 |