| NPI | 1194801423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036145121) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 38265) |
| 207Q00000X Family Medicine (Licence: OR MD174267) | |
| 207Q00000X Family Medicine (Licence: TN 63709) | |
| 207Q00000X Family Medicine (Licence: WA IMLC.MD.61177379) | |
| 207Q00000X Family Medicine (Licence: MD D0091274) | |
| 207Q00000X Family Medicine (Licence: MI EMC0000985) | |
| 207Q00000X Family Medicine (Licence: MN 69093) | |
| 207Q00000X Family Medicine (Licence: MS 28796) | |
| 207Q00000X Family Medicine (Licence: CA c173607) | |
| 207Q00000X Family Medicine (Licence: GA 88637) | |
| 207Q00000X Family Medicine (Licence: CO CDR.0001116) | |
| 207Q00000X Family Medicine (Licence: NV 21058) | |
| 207Q00000X Family Medicine (Licence: AZ 63855) | |
| 207Q00000X Family Medicine (Licence: AL 42474) | |
| Enumeration Date | 2006-10-30 |
| Last Update Date | 2022-07-28 |