| NPI | 1659603256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101250187) |
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: VA 0101250187) |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2023-01-24 |