| NPI | 1184771347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K7137) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME112104) |
| 207Q00000X Family Medicine (Licence: CT 49540) | |
| 207Q00000X Family Medicine (Licence: CA 54537) | |
| 207Q00000X Family Medicine (Licence: AR E-10703) | |
| 207Q00000X Family Medicine (Licence: NM TM2010-0736) | |
| 207Q00000X Family Medicine (Licence: NC 2011-00164) | |
| 207Q00000X Family Medicine (Licence: MO 2010042080) | |
| 207Q00000X Family Medicine (Licence: MN 1458) | |
| 207Q00000X Family Medicine (Licence: MI 4301097537) | |
| 207Q00000X Family Medicine (Licence: MA 249804) | |
| 207Q00000X Family Medicine (Licence: KY 44505) | |
| 207Q00000X Family Medicine (Licence: IN 07078685A) | |
| 207Q00000X Family Medicine (Licence: IL 036128916) | |
| 207Q00000X Family Medicine (Licence: GA 065528) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2019-07-24 |