| NPI | 1306108105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: UT 9791717-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036130096) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2021-10-28 |