| NPI | 1710167655 |
|---|---|
| Professional Name | BRADLEY JOHNSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 3202) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 956) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2020-11-03 |