| NPI | 1013163849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D72895) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101246121) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: VA 0101246121) | |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2022-04-02 |