A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Physician Assistant | 363A00000X |
| Pain Medicine | 208VP0000X | |
| Surgical | 363AS0400X |
* Indicates primary specialty
| NPI Number | 1124091095 |
| Credentials | PA-C (Physician Assistant-Certified) |
| Entity | Individual |
| Enumeration date | 02/09/2006 |
| Last updated | 10/29/2025 - About 7 months ago |
| Sole proprietor1 | No |
| Identifiers |
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| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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