| NPI | 1003235367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics Clinical Genetics (M.D.) (Licence: DC MD044433) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD044433) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2020-04-17 |