Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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NPI 1083812432

Individual provider · NPI 1083812432 Deactivated

This NPI was deactivated on September 10, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1083812432 is listed in the national NPI registry.

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Record details

NPI number1083812432
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—