Professional details
NPI 1023213238 · Taxonomy 207Q00000X · Updated Aug 5, 2021
These are reported specialties, not confirmation of primary-care availability.
NPI 1023213238 · Taxonomy 207Q00000X · Updated Aug 5, 2021
NPI 1598576498 · Taxonomy 363LF0000X · Updated Apr 11, 2025
NPI 1659067874 · Taxonomy 207R00000X · Updated Jun 4, 2026
NPI 1003438870 · Taxonomy 207R00000X · Updated Aug 18, 2026
NPI 1801536065 · Taxonomy 207Q00000X · Updated Aug 31, 2026
NPI 1487507273 · Taxonomy 363LF0000X · Updated Feb 19, 2026
NPI 1790428613 · Taxonomy 207Q00000X · Updated Jul 2, 2026
NPI 1306074299 · Taxonomy 363LF0000X · Updated Mar 18, 2014
NPI 1497138101 · Taxonomy 363LF0000X · Updated Jun 30, 2015
NPI 1609409341 · Taxonomy 363LF0000X · Updated Feb 21, 2020
NPI 1619479235 · Taxonomy 363LF0000X · Updated Feb 2, 2023
NPI 1750969242 · Taxonomy 207R00000X · Updated Jul 7, 2025