| NPI | 1801897467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G48045) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2015-0902) |
| 207Q00000X Family Medicine (Licence: AZ 51255) | |
| 207Q00000X Family Medicine (Licence: KS 04-38541) | |
| 207Q00000X Family Medicine (Licence: HI 18501) | |
| 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-58030) | |
| 207Q00000X Family Medicine (Licence: MD D0080439) | |
| 207Q00000X Family Medicine (Licence: UT 9511618-1205) | |
| 207Q00000X Family Medicine (Licence: NV 16147) | |
| 207Q00000X Family Medicine (Licence: WI 64990-20) | |
| 207Q00000X Family Medicine (Licence: IN 01076230A) | |
| 207Q00000X Family Medicine (Licence: AK 119238) | |
| 207Q00000X Family Medicine (Licence: OR MD1809058) | |
| 207Q00000X Family Medicine (Licence: CO DR.0057991) | |
| 207Q00000X Family Medicine (Licence: WA md00028215) | |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2022-07-21 |