| NPI | 1710388319 |
|---|---|
| Former Name | NICOLE ANN FEENEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017982) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 017982) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2018-08-09 |