| NPI | 1003201963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 292753) |
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: MA 292753) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2022-07-11 |