| NPI | 1255334983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: VA 0101222052) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101222052) |
| Enumeration Date | 2005-05-26 |
| Last Update Date | 2024-05-28 |