| NPI | 1760933923 |
|---|---|
| Former Name | NATHAN TODD MCDELAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 5927) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 084760) |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2023-02-03 |