| NPI | 1275762411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: TX N3033) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N3033) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2011-01-07 |