NPI | 1912170598 |
---|---|
Former Name | NICOLE MARIE WAKIM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 127642) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A98851) |
Enumeration Date | 2008-04-04 |
Last Update Date | 2023-12-18 |