| NPI | 1104825751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 216969) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C53583) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: NY 216969) | |
| Enumeration Date | 2005-07-17 |
| Last Update Date | 2024-01-03 |