NPI | 1356051098 |
---|---|
Other Name | NICHOLAS J CRODICK |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009381) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2022-12-05 |
Last Update Date | 2023-11-21 |