| NPI | 1164541181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: CA C168510) |
| Additional Taxonomies | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: PA MD421927) |
| 208000000X Pediatrics (Licence: PA MD421927) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-04-30 |