| NPI | 1215381314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: NY 299042) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2021-08-25 |