Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 40658 | FL |
NPI | 1720103633 |
---|---|
Provider Name | Mr. Nick Gregory Abram |
First Address | Cape Coral, FL 33909-1969 |
Second Address | Cape Coral, FL 33909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |