| NPI | 1851301204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N4218) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E0011) |
| 207Q00000X Family Medicine (Licence: NC 2019-02461) | |
| 207Q00000X Family Medicine (Licence: NY 307784) | |
| 207Q00000X Family Medicine (Licence: AL 00041561) | |
| 207Q00000X Family Medicine (Licence: OH 35.136341) | |
| 207Q00000X Family Medicine (Licence: OK 29064) | |
| 207Q00000X Family Medicine (Licence: IL 036152980) | |
| 207Q00000X Family Medicine (Licence: SC 52754) | |
| 207Q00000X Family Medicine (Licence: NJ 25MA11002300) | |
| 207Q00000X Family Medicine (Licence: NH 18154) | |
| 207Q00000X Family Medicine (Licence: AZ 56860) | |
| 207Q00000X Family Medicine (Licence: CO DR.0063249) | |
| 207Q00000X Family Medicine (Licence: SD 10285) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2022-12-20 |