Professional details
NPI 1710500228 · Taxonomy 363L00000X · Updated Aug 23, 2021
These are reported specialties, not confirmation of primary-care availability.
NPI 1710500228 · Taxonomy 363L00000X · Updated Aug 23, 2021
NPI 1720309545 · Taxonomy 207R00000X · Updated Dec 12, 2025
NPI 1588321582 · Taxonomy 363LF0000X · Updated Mar 23, 2023
NPI 1124092135 · Taxonomy 207Q00000X · Updated Sep 1, 2020
NPI 1861547762 · Taxonomy 207R00000X · Updated Aug 27, 2025
NPI 1235691627 · Taxonomy 207R00000X · Updated Aug 4, 2022
NPI 1235672163 · Taxonomy 363LF0000X · Updated Feb 6, 2017
NPI 1770965873 · Taxonomy 207Q00000X · Updated Jun 24, 2015
NPI 1144232406 · Taxonomy 207R00000X · Updated Mar 25, 2021
NPI 1992754964 · Taxonomy 207Q00000X · Updated Apr 15, 2010
NPI 1629114335 · Taxonomy 207Q00000X · Updated Jan 4, 2021
NPI 1194353169 · Taxonomy 207R00000X · Updated Oct 16, 2024