| NPI | 1063402840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: TX H5095) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX H5095) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2023-03-07 |