| NPI | 1346282381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 8157) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0037516) |
| 207Q00000X Family Medicine (Licence: CA G137017) | |
| 207Q00000X Family Medicine (Licence: MN 57625) | |
| 207Q00000X Family Medicine (Licence: NV 16119) | |
| 207Q00000X Family Medicine (Licence: WA MD00033181) | |
| 207Q00000X Family Medicine (Licence: OR MD171673) | |
| 207Q00000X Family Medicine (Licence: TX R0304) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2018-03-17 |