| 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 |