NPI | 1962060699 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD223741) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.148464) |
207Q00000X Family Medicine (Licence: CA A200678) | |
2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: OR MD223741) | |
Enumeration Date | 2019-05-29 |
Last Update Date | 2025-06-29 |