| NPI | 1487827101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2017-00592) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2017-00592) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: NC 2017-00592) | |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2022-11-02 |