| NPI | 1679202139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR DO225355) |
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: OR DO225355) |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2026-07-01 |