| NPI | 1003947649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: WI 73175-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 73175-20) |
| 208000000X Pediatrics (Licence: PA MT 189428) | |
| 208000000X Pediatrics (Licence: DE C7000-3519) | |
| 208000000X Pediatrics (Licence: WA MD60085554) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2022-08-01 |