| NPI | 1700153640 |
|---|---|
| Other Name | NICOLE MARIE DIMITT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 5083) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5083) |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 5083) | |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2013-03-29 |