| NPI | 1073617460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics Clinical Genetics (M.D.) (Licence: CA C134246) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C134246) |
| 208000000X Pediatrics (Licence: UT 51508821205) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2024-04-16 |