| NPI | 1215926324 |
|---|---|
| Other Name | GALEN CARLOS NELSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 1133-23) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085-001248) |
| 363AM0700X Physician Assistant, Medical (Licence: WI 1133-023) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2021-10-07 |