| NPI | 1174518955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: IA 30001) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 30001) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2021-09-10 |