| NPI | 1477233765 |
|---|---|
| Former Name | BRANDYN M WARDELL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA63516) |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2025-08-05 |