Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | G1000818 | DE |
Y | 213EG0000X | General Practice | G1000818 | DE |
NPI | 1003916537 |
---|---|
Provider Name | Dr. David Benedict Nibouar |
First Address | Wilmington, DE 19808-1252 |
Second Address | Wilmington, DE 19808-1252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2006 |
Last Update Date | 08/07/2007 |