Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 8761 | AZ |
N | 111NN0400X | Neurology | 1422 | OR |
NPI | 1063580348 |
---|---|
Provider Name | Dr. Robert Sherman |
First Address | Green Valley, AZ 85622-4648 |
Second Address | Green Valley, AZ 85622-4648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2006 |
Last Update Date | 08/05/2019 |