| NPI | 1043243066 |
|---|---|
| Former Name | THERESA DALMASSE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 003515) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 003515) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2019-12-06 |