| NPI | 1831779388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: MA 1023932) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 39617) |
| 207Q00000X Family Medicine (Licence: MA 1023932) | |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2025-07-15 |