| NPI | 1225795719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA A-197290) |
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: MN 79260) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 79260) | |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2025-03-14 |