| NPI | 1932543857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD49697) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 36859) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: IA MD49697) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2022-08-29 |