| NPI | 1962775288 |
|---|---|
| Former Name | KYLE ANDREW HASENSTEIN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA57843) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055054) |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2023-09-19 |