| NPI | 1760612758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME141543) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0013233) |
| 207Q00000X Family Medicine (Licence: GA 83752) | |
| 207Q00000X Family Medicine (Licence: DC MD048606) | |
| 207Q00000X Family Medicine (Licence: AR E-13728) | |
| 207Q00000X Family Medicine (Licence: AL MD.41197) | |
| 207Q00000X Family Medicine (Licence: AK 168126) | |
| 207Q00000X Family Medicine (Licence: AZ 61473) | |
| 207Q00000X Family Medicine (Licence: CO DR.0063260) | |
| 207Q00000X Family Medicine (Licence: PA MD468058) | |
| 207Q00000X Family Medicine (Licence: SC MMD.83213MD) | |
| 207Q00000X Family Medicine (Licence: VA 0101248055) | |
| 207Q00000X Family Medicine (Licence: IL 036.150514) | |
| 207Q00000X Family Medicine (Licence: CA C-165448) | |
| 207Q00000X Family Medicine (Licence: CT 66918) | |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2023-10-02 |