| NPI | 1780913574 |
|---|---|
| Former Name | NICOLE WHEELER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07531) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 1090664) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2019-12-03 |