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Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1467950154

Individual Registrant:
Gender: M
Not Sole Proprietor

Location and contact information for practice:
Tel: 775-750-7159  Fax: 775-738-3222

Contact information for business:
Tel: 775-750-7159  Fax: 775-738-3222

Registration Information:
NPI: 1467950154
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant

Legacy codes, insurance codes and state license numbers:



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