| NPI | 1093101248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 29933) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A154119) |
| 207Q00000X Family Medicine (Licence: IL 36.16363) | |
| 207Q00000X Family Medicine (Licence: AL 45880) | |
| 207Q00000X Family Medicine (Licence: MI EMC0002980) | |
| 207Q00000X Family Medicine (Licence: AZ 69289) | |
| 207Q00000X Family Medicine (Licence: FL ME162230) | |
| 207Q00000X Family Medicine (Licence: GA 94754) | |
| 207Q00000X Family Medicine (Licence: OH 35.140278) | |
| 207Q00000X Family Medicine (Licence: TX U2109) | |
| 207Q00000X Family Medicine (Licence: WA IMLC.MD.61408269) | |
| 207Q00000X Family Medicine (Licence: WI 2731-320) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2023-11-07 |