| NPI | 1265797617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: UT 10386880-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2012018921) |
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: PA MD462049) | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2025-12-19 |