| NPI | 1649627811 |
|---|---|
| Former Name | ERIC CHRISTOPHER DIBIASIO-WHITE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5815) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA5815) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2021-11-17 |