| NPI | 1396414413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246YC3302X Spec/Tech, Health Info, Coding Specialist, Physician Office Based (Licence: VA 220595) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 246Y00000X Spec/Tech, Health Info | |
| Enumeration Date | 2021-09-11 |
| Last Update Date | 2024-10-16 |