| NPI | 1114949617 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: PA MD419612)  | 
| Additional Taxonomies | 207SG0202X Medical Genetics, Clinical Biochemical Genetics (Licence: PA MD419612)  | 
| 208000000X Pediatrics (Licence: PA MD419612)  | |
| Enumeration Date | 2006-07-24 | 
| Last Update Date | 2013-04-19 |