| NPI | 1861731564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101256697) |
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: WA MD60820943) |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2024-08-22 |