NPI | 1902328875 |
---|---|
Former Name | NICOLE STAHL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA62335) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7483) |
Enumeration Date | 2017-07-12 |
Last Update Date | 2024-07-19 |