| NPI | 1073903803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2016-0585) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 65444-20) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: NM MD2016-0585) | |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2020-05-19 |