| NPI | 1164083572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: PA MD480728) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: PA MD480728) |
| 208000000X Pediatrics (Licence: PA MD480728) | |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2024-10-28 |