| 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 |