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Individual
ZIN OO
Active
Individual
ZIN OO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125075464
IL
207Q00000X
Family Medicine Physician
Primary
325818
NY
Other
Enumeration date
06/08/2020
Last updated
09/26/2023
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