| NPI | 1710275102 |
|---|---|
| Former Name | NICOLE MARIE ROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS017375) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2020-09-15 |