| NPI | 1871859892 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A128184)  | 
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: CA A128184)  | 
| Enumeration Date | 2012-04-03 | 
| Last Update Date | 2024-04-24 |