| NPI | 1164042297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: AZ 010205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 010205) |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2026-01-22 |