| NPI | 1063746485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0203X Medical Genetics, Clinical Molecular Genetics (Licence: FL ME125766) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME125766) |
| 208D00000X General Practice (Licence: NC 2023-02684) | |
| 208D00000X General Practice (Licence: CA C194982) | |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2024-03-25 |