| NPI | 1740971407 |
|---|---|
| Former Name | NICOLE MARIE PULLIAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405129) |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2023-06-28 |