ISRAEL DANIEL LARGE

GRANDVIEW, MO
NPI1609616259
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-05-30
Last Update Date2024-12-02
Business Address
ISRAEL DANIEL LARGE MD
13013 FULLER AVE STE A
GRANDVIEW, MO 64030-2687
Phone number: 915-867-0499
Mailing Address
ISRAEL DANIEL LARGE MD
1501 E WHITTON AVE APT 302
PHOENIX, AZ 85014-5180
Phone number: 915-867-0499
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