Mickoyan Nakita Poole, PA-C Valid NPI

Individual provider · Physician Assistant · Rialto, CA

NPI

1316201734

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

15766 (CA)

Sex

Male

Sole proprietor

Yes

Enumerated

2012-06-29

Last updated

2022-02-07