| NPI | 1174059190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: NE 32560) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 227670) |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2026-04-09 |