| NPI | 1164432720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2206028760) |
| Additional Taxonomies | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MI 4301049958) |
| 208000000X Pediatrics (Licence: MI 4301049958) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2011-08-16 |