| NPI | 1972974244 |
|---|---|
| Former Name | NICHELLE HARRISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036178542) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2020017990) |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2026-08-05 |