| NPI | 1942552674 |
|---|---|
| Former Name | ERICKA NICOLE FAGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03844) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-03844) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2020-10-26 |