| NPI | 1134135130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 23926) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 86994) |
| 207Q00000X Family Medicine (Licence: TX S5639) | |
| 207Q00000X Family Medicine (Licence: NY 304100) | |
| 207Q00000X Family Medicine (Licence: WI 742-320) | |
| 207Q00000X Family Medicine (Licence: SD 11947) | |
| 207Q00000X Family Medicine (Licence: NC 2020-00796) | |
| 207Q00000X Family Medicine (Licence: MN 66988) | |
| 207Q00000X Family Medicine (Licence: CO CDR.0000656) | |
| 207Q00000X Family Medicine (Licence: IL 036.152227) | |
| 207Q00000X Family Medicine (Licence: OH 35.138831) | |
| 207Q00000X Family Medicine (Licence: PA MD471166) | |
| 207Q00000X Family Medicine (Licence: MI EMC0000218) | |
| 207Q00000X Family Medicine (Licence: IN 01083698A) | |
| 207Q00000X Family Medicine (Licence: KY 54014) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2021-07-27 |