| NPI | 1134429566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 45599) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036057173) |
| 207Q00000X Family Medicine (Licence: AL MD.24022) | |
| 207Q00000X Family Medicine (Licence: FL ME84432) | |
| 207Q00000X Family Medicine (Licence: MD D58739) | |
| 207Q00000X Family Medicine (Licence: NC 200100599) | |
| 207Q00000X Family Medicine (Licence: SC 22722) | |
| 207Q00000X Family Medicine (Licence: TN 35657) | |
| 207Q00000X Family Medicine (Licence: LA MD.14336R) | |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2010-11-02 |