| NPI | 1780839605 |
|---|---|
| Other Name | DAN NICHOLS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 074769) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 0000000865) |
| 363A00000X Physician Assistant (Licence: IL 085005376) | |
| 363AM0700X Physician Assistant, Medical (Licence: TN 2401) | |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2025-04-04 |