| NPI | 1265810691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV DO2502) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R8878) |
| 207Q00000X Family Medicine (Licence: AR E-11892) | |
| 207Q00000X Family Medicine (Licence: ND 15482) | |
| 207Q00000X Family Medicine (Licence: OK 6550) | |
| 207Q00000X Family Medicine (Licence: MO 2019000361) | |
| 207Q00000X Family Medicine (Licence: LA 312293) | |
| 207Q00000X Family Medicine (Licence: AL DO.2059) | |
| 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-78315) | |
| 207Q00000X Family Medicine (Licence: UT 11418132-1204) | |
| 207Q00000X Family Medicine (Licence: MD H88113) | |
| 207Q00000X Family Medicine (Licence: ME DO2975) | |
| 207Q00000X Family Medicine (Licence: AZ 008193) | |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2019-09-16 |