NPI | 1831695451 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35C.001517) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR0062867) |
207Q00000X Family Medicine (Licence: OK 45899) | |
207Q00000X Family Medicine (Licence: WA IMLC.MD.61552720) | |
207Q00000X Family Medicine (Licence: TX V0597) | |
207Q00000X Family Medicine (Licence: NV 25577) | |
207Q00000X Family Medicine (Licence: AZ 73665) | |
Enumeration Date | 2018-04-03 |
Last Update Date | 2025-05-29 |