| NPI | 1336644178 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A167056) | 
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: CA A167056) | 
| Enumeration Date | 2018-03-26 | 
| Last Update Date | 2025-09-03 |