| NPI | 1013355973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125063654) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 37469) |
| 207Q00000X Family Medicine (Licence: AR E-13528) | |
| 207Q00000X Family Medicine (Licence: IN 01084463A) | |
| 207Q00000X Family Medicine (Licence: LA 310369) | |
| 207Q00000X Family Medicine (Licence: MI 4301502824) | |
| 207Q00000X Family Medicine (Licence: MS 26170) | |
| 207Q00000X Family Medicine (Licence: NY 303086-01) | |
| 207Q00000X Family Medicine (Licence: NC 2020-03214) | |
| 207Q00000X Family Medicine (Licence: OH 35.140368) | |
| 207Q00000X Family Medicine (Licence: PA MD471358) | |
| 207Q00000X Family Medicine (Licence: TN 60271) | |
| 207Q00000X Family Medicine (Licence: TX S5189) | |
| 207Q00000X Family Medicine (Licence: MO 2020041318) | |
| 207Q00000X Family Medicine (Licence: OK 36935) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2022-04-07 |