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Physician Last Name Physician First Name Physician Middle Name License Number License Type Effective Date Date Updated Year of Birth
Tabakman Roman M. 183984 MD 04/22/2021 06/21/2021 1955
Simmons Warren B. 174483 MD 06/25/2021 06/18/2021 1956
Trotta Eugene T. 002925 PA 06/25/2021 06/18/2021 1948
Trotta Eugene T. 002925 PA 06/25/2021 06/18/2021 1948
Bruni Larry M. 275946 MD 06/24/2021 06/17/2021 1951
Smith Frank J. 014903 PA 06/24/2021 06/17/2021 1981
Kahan Brian S. 191804 DO 06/07/2021 06/16/2021 1965
Stahl Jonathan 287113 DO 06/22/2021 06/15/2021 1977
Krueger Lance S. 003160 PA 06/22/2021 06/15/2021 1958
Harrie Robert Raymond 277054 MD 06/22/2021 06/15/2021 1957
Kamath Giridhar C. 230087 DO 06/18/2021 06/11/2021 1974
Van Thiel David 102216 MD 06/18/2021 06/11/2021 1941
Nisar Mohammed P. 122933 MD 06/16/2021 06/10/2021 1941
Mirkia-Langroudi Kiarash 240608 MD 06/16/2021 06/10/2021 1967
Farhi Manuela B. 297213 MD 06/17/2021 06/10/2021 1957
Malik Nayyera Batool 200418 MD 05/21/2021 06/09/2021 1962
Dunphy Daniel J. 001437 PA 06/14/2021 06/07/2021 1948
Iqbal Zafar 170745 MD 05/21/2021 06/04/2021 1954
Hernandez Nicole 014714 PA 06/01/2021 06/03/2021 1985
Santiamo Joseph P. 157471 MD 06/10/2021 06/03/2021 1955
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