| NPI | 1962155242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 2470A2800X Technician, Health Information, Assistant Record Technician |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2023-12-21 |