| NPI | 1396998241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 31177) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T1646) |
| 207Q00000X Family Medicine (Licence: NY 268476) | |
| 207Q00000X Family Medicine (Licence: MI 4301506264) | |
| 207Q00000X Family Medicine (Licence: FL ME116130) | |
| 207Q00000X Family Medicine (Licence: KY 45687) | |
| 207Q00000X Family Medicine (Licence: OK 31199) | |
| 207Q00000X Family Medicine (Licence: AR E-8263) | |
| 207Q00000X Family Medicine (Licence: CA C53908) | |
| 207Q00000X Family Medicine (Licence: NJ 25MA08705100) | |
| 207Q00000X Family Medicine (Licence: WY 10120A) | |
| 207Q00000X Family Medicine (Licence: NC 2021-02326) | |
| 207Q00000X Family Medicine (Licence: ME EL201612) | |
| 207Q00000X Family Medicine (Licence: GA 65524) | |
| 207Q00000X Family Medicine (Licence: VA 0101249511) | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2024-05-06 |