NPI | 1841229937 |
---|---|
Former Name | NICOLE A REIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 3638) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9103458) |
Enumeration Date | 2006-07-01 |
Last Update Date | 2013-05-16 |