| NPI | 1255381794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: TX E5829) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX E5829) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2014-06-17 |