| NPI | 1841532637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-39265) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2015016398) |
| 207Q00000X Family Medicine (Licence: IA DO-05296) | |
| 207Q00000X Family Medicine (Licence: MN 64762) | |
| 207Q00000X Family Medicine (Licence: WA OP60914447) | |
| 207Q00000X Family Medicine (Licence: WI 41-321) | |
| 207Q00000X Family Medicine (Licence: AZ 007851) | |
| 207Q00000X Family Medicine (Licence: IL 036147727) | |
| 207Q00000X Family Medicine (Licence: NE 1957) | |
| 207Q00000X Family Medicine (Licence: SD 11317) | |
| 207Q00000X Family Medicine (Licence: CO CDR.0000392) | |
| 207Q00000X Family Medicine (Licence: UT 11309988-1204) | |
| 207Q00000X Family Medicine (Licence: ME DO2940) | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2020-05-14 |