| NPI | 1245204635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207SG0202X Medical Genetics Clinical Biochemical Genetics (Licence: WA MD00048021) |
| Additional Taxonomies | 207SG0201X Medical Genetics Clinical Genetics (M.D.) (Licence: WA MD00048021) |
| 208000000X Pediatrics (Licence: WA MD00048021) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2016-11-18 |