| NPI | 1578090189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A169863) |
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: CA A169863) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 228690) | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2024-04-18 |