| NPI | 1255399051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: OH 35.067903) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-06-7903-B) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: OH 35.067903) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2021-11-02 |