| NPI | 1679859391 |
|---|---|
| Former Name | NIKKI LYNN SERGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA055147) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2012-12-10 |