Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

NPI 1174690234

Individual provider · NPI 1174690234 Deactivated

This NPI was deactivated on September 24, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1174690234 is listed in the national NPI registry.

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Record details

NPI number1174690234
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—