| NPI | 1629443957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA C210640) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C210640) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: CA C210640) | |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2026-07-28 |