Jacob Moore, PA-C Valid NPI

Individual provider · Physician Assistant · New Brighton, MN

NPI

1851780928

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

Sex

Male

Sole proprietor

No

Enumerated

2015-01-13

Last updated

2015-04-27