| NPI | 1821052242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: WA MD0041655) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: TN 63516) |
| 207QA0505X Family Medicine Adult Medicine (Licence: SC 86632) | |
| 207QA0505X Family Medicine Adult Medicine (Licence: NC 2021-02364) | |
| 207QA0505X Family Medicine Adult Medicine (Licence: CO DR.0066357) | |
| 207QA0505X Family Medicine Adult Medicine (Licence: FL TPME5081) | |
| 207QA0505X Family Medicine Adult Medicine (Licence: AZ 63645) | |
| 207QA0505X Family Medicine Adult Medicine (Licence: TX U1456) | |
| 207QA0505X Family Medicine Adult Medicine (Licence: OH 35C.000339) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2023-11-27 |