| NPI | 1992719371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 070764) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036159042) |
| 207Q00000X Family Medicine (Licence: WA MD61258786) | |
| 207Q00000X Family Medicine (Licence: TX T6468) | |
| 207Q00000X Family Medicine (Licence: IA MD-49368) | |
| 207Q00000X Family Medicine (Licence: AZ 65671) | |
| 207Q00000X Family Medicine (Licence: KY 52347) | |
| 207Q00000X Family Medicine (Licence: SC 87337) | |
| 207Q00000X Family Medicine (Licence: LA 329649) | |
| 207Q00000X Family Medicine (Licence: FL ME138774) | |
| 207Q00000X Family Medicine (Licence: NV 21854) | |
| 207Q00000X Family Medicine (Licence: CO DR.0060480) | |
| 207Q00000X Family Medicine (Licence: PA MD466294) | |
| 207Q00000X Family Medicine (Licence: CT 62246) | |
| 207Q00000X Family Medicine (Licence: TN 58719) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2022-10-31 |