| NPI | 1083595730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY STEFFEN DAHL Physician Assistant 347-964-3084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2025-09-09 |
| Last Update Date | 2025-11-17 |