| NPI | 1497240121 |
|---|---|
| Former Name | DOROTHY ANN SCULL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA195766) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2021-01-18 |