Professional details
NPI 1538975198 · Taxonomy 363LF0000X · Updated Jul 1, 2025
These are reported specialties, not confirmation of primary-care availability.
NPI 1538975198 · Taxonomy 363LF0000X · Updated Jul 1, 2025
NPI 1417899469 · Taxonomy 363LF0000X · Updated Apr 8, 2026
NPI 1750715413 · Taxonomy 363L00000X · Updated Jan 15, 2026
NPI 1194315606 · Taxonomy 363LF0000X · Updated Nov 10, 2022
NPI 1487251880 · Taxonomy 363LF0000X · Updated Feb 2, 2024
NPI 1104644376 · Taxonomy 207Q00000X · Updated Sep 17, 2025
NPI 1366304107 · Taxonomy 363LP2300X · Updated Dec 1, 2025
NPI 1528702453 · Taxonomy 207Q00000X · Updated Jul 29, 2025
NPI 1235623950 · Taxonomy 363LF0000X · Updated Aug 27, 2021
NPI 1164848057 · Taxonomy 363L00000X · Updated Dec 9, 2015
NPI 1740930585 · Taxonomy 207Q00000X · Updated Sep 8, 2025
NPI 1295253557 · Taxonomy 363L00000X · Updated Feb 20, 2019