| NPI | 1609062132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIRELL L NYGAARD President & Sole Owner 209-588-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA18044) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2009-05-20 |