Professional details
NPI 1811909948 · Taxonomy 207Q00000X · Updated May 2, 2024
These are reported specialties, not confirmation of primary-care availability.
NPI 1811909948 · Taxonomy 207Q00000X · Updated May 2, 2024
NPI 1417571258 · Taxonomy 363L00000X · Updated Jun 7, 2020
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NPI 1689917163 · Taxonomy 207R00000X · Updated May 3, 2022
NPI 1689337800 · Taxonomy 363LF0000X · Updated Mar 4, 2026
NPI 1497558076 · Taxonomy 207Q00000X · Updated Jun 16, 2025
NPI 1356081475 · Taxonomy 207R00000X · Updated Jul 23, 2025
NPI 1174984421 · Taxonomy 207Q00000X · Updated Dec 7, 2023
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NPI 1780061812 · Taxonomy 207R00000X · Updated Dec 5, 2025
NPI 1962713727 · Taxonomy 207Q00000X · Updated Oct 11, 2022