| NPI | 1215483961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 327606-01) |
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: CA A142645) |
| 208000000X Pediatrics (Licence: CA A142645) | |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: NY 327606-01) | |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2026-01-22 |