| NPI | 1740505825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0438970) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 15464) |
| 207Q00000X Family Medicine (Licence: SD 10907) | |
| 207Q00000X Family Medicine (Licence: NE 30826) | |
| 207Q00000X Family Medicine (Licence: MO 2016031442) | |
| 207Q00000X Family Medicine (Licence: AZ 56596) | |
| 207Q00000X Family Medicine (Licence: IL 036145932) | |
| 207Q00000X Family Medicine (Licence: LA 309387) | |
| 207Q00000X Family Medicine (Licence: OR MD187007) | |
| 207Q00000X Family Medicine (Licence: OK 33674) | |
| 207Q00000X Family Medicine (Licence: NV 17883) | |
| 207Q00000X Family Medicine (Licence: TN 57400) | |
| 207Q00000X Family Medicine (Licence: CA C156047) | |
| 207Q00000X Family Medicine (Licence: AL MD.36988) | |
| 207Q00000X Family Medicine (Licence: TX R9780) | |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2023-04-04 |