| NPI | 1063486454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MA 1206) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 28697) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2012-07-20 |