| NPI | 1174507073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60604622) |
| Additional Taxonomies | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MT 12316) |
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: WA MD60604622) | |
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: CA A40286) | |
| 207SG0207X Medical Genetics, Medical Biochemical Genetics (Licence: WA MD60604622) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2023-10-03 |