| NPI | 1902359383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAMODA FATEHCHAND Psysician Assistant 740-201-6021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003529) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2023-07-25 |