NPI | 1457328221 |
---|---|
Former Name | RICHARD HERNANDEZ |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: RI PA00382) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: RI PA00382) |
Enumeration Date | 2006-03-01 |
Last Update Date | 2020-01-29 |