| NPI | 1619473733 |
|---|---|
| Former Name | NICOLE BUTUZOV |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 295367) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 311861) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2025-11-06 |