| NPI | 1174799944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 278153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 265062) |
| 207Q00000X Family Medicine (Licence: IL 36138997) | |
| 207Q00000X Family Medicine (Licence: MI 4301110449) | |
| 207Q00000X Family Medicine (Licence: DC MD042785) | |
| 207Q00000X Family Medicine (Licence: PA MD457790) | |
| 207Q00000X Family Medicine (Licence: FL ME130291) | |
| 207Q00000X Family Medicine (Licence: IN 01076738A) | |
| 207Q00000X Family Medicine (Licence: VA 101260142) | |
| 207Q00000X Family Medicine (Licence: CO DR.55071) | |
| 207Q00000X Family Medicine (Licence: OH 35.129569) | |
| 207Q00000X Family Medicine (Licence: CT 1.055403) | |
| 207Q00000X Family Medicine (Licence: NC 2016-01630) | |
| 207Q00000X Family Medicine (Licence: NJ 25MA09870700) | |
| 207Q00000X Family Medicine (Licence: CA A110180) | |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2024-06-25 |