| NPI | 1689855561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C186903) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 243293) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: MA 243293) | |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2025-04-30 |