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

NPI 1306544044

Individual provider · NPI 1306544044 Deactivated

This NPI was deactivated on October 25, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1306544044 is listed in the national NPI registry.

Practice location Incomplete address

The federal record is missing the street or ZIP for this provider.

Specialties & licences

Record details

NPI number1306544044
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—