| NPI | 1306076039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: TN 65362) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 65362) |
| 208D00000X General Practice (Licence: PA MD436046) | |
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: CA C1422548) | |
| 208000000X Pediatrics (Licence: IA 39570) | |
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: PA MT194028) | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2024-01-25 |