| NPI | 1588728596 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: TX J3607)  | 
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: GA 058643)  | 
| Enumeration Date | 2006-12-21 | 
| Last Update Date | 2022-05-23 |