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

NPI 1366776197

Individual provider · NPI 1366776197 Deactivated

This NPI was deactivated on September 19, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1366776197 is listed in the national NPI registry.

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Record details

NPI number1366776197
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—