| NPI | 1184041360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: CA A141789) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A141789) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2020-06-10 |