| NPI | 1902057227 |
|---|---|
| Professional Name | HENRY ALIX MOMBELEUR |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 004034-1) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 004034-1) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2008-10-06 |